Abstract

Background:
Drug dependence is one of the major problems in today’s world which has turned into a serious, concerning threat due to its destructive and preventive effects on the development and prosperity of the society.

Objectives:
The study aimed to investigate the effectiveness of social skills training on tendency to addiction among high school female students of Ahvaz city.

Patients and Methods:
The population of this study consisted of all female students in Ahvaz city high schools, who scored one standard deviation higher than the mean in the zargar addiction potential questionnaire. Out of them, 40 students were selected by random sampling method and classified into two experimental and control groups (20 persons in each group). Eight treatment sessions were scheduled for the experimental group. In these sessions, social skills such as assertiveness, anger management, and communication with others were instructed to the group whereas, the control group received no training. Evaluation device wasscattere zargar addiction potential questionnaire.

Results:
The results of the analysis of covariance (ANCOVA) test showed that there was a significant difference between the tendency to addiction reduction scores in control and experimental groups (P < 0.01). The results indicated that training the social skills were effective to reduce the tendency to addiction reduction in high school female students of Ahvaz.

Conclusions:
Teaching the appropriate social skills is effective in reducing the tendency to addiction among the students.

1. Background

Addiction is seen among all socioeconomic classes and does not belong to a special social class. With regard to the high rate of drug dependence and difficulties in its treatment, it is necessary to identify the factors contributing to this problem in societies. Addiction is one of the problems that have been threatening the human society. Drug abuse is a phenomenon that has been spread within different communities during recent years. Investigating and finding the underlying causes of this problem require a time-consuming research in various fields (1).

Drugs addiction is a result of using the calming and hallucinatory substances so frequently that the addicted is involved in it severely. The addicted person feels unable to quit or reduce its consumption and keeps using the drug increasingly. They think that they would be poisoned in case of quitting it. In medical sciences the term “dependence” is used for "addiction" interchangeably. The addict is the person who mentally and physically depends on a drug (2). Today, drug abuse is considered one of the important social problems that not only endangers the health of the individual and society, but also induces the mental and moral degeneration (3).

Nowadays, addiction is one of the main problems of human societies and continually takes more new dimensions. Now the addiction of adolescents is an alarm for the government. The United Nations has designated the 26th of June as the International Day against Drug. Failing to establish an emotional relationship with their parents, adolescents bridge this gap by drugs (4). Drug use by poor adolescents compared with the rich ones is gradually increasing in the coming years (5). Nineteen percent of the junior high school students are reported to use cigarette, alcoholic drinks or drugs at least once in their lives (6).

According to the results of this study, 14.7% of the students are reported to use cigarettes, 9.8%, alcoholic drinks, and 0.05% drugs. The strongest predictors of drugs use among the adolescents were family conflicts, depression, anxiety, stress, positive attitudes and beliefs towards the drugs (7). In a research, the relationship between the identity status and recreational use of drugs was investigated among the adolescents in the 7th to 12th grades in Arizona State. The researchers found that in contrast to the adolescents with imposed identity, the adolescents with scattered identity were involved in smoking, using alcohol, and inhaling drugs (like cocaine), two, three, and five times more than the imposed ones, respectively. These researchers reported the high rate of drug abuse among the adolescents in successful status and deferred identity rather than those with imposed and sporadic identities (8).

In the United States, primary prevention has been mainly associated with the educational approach about the consequences of drug use. However, the empirical findings suggest that using this method alone is ineffective and even with the adolescents who are curious in this case it may increase the probability of abuse. The present research is not pessimistic about the training; however, relying solely on a single factor and ignoring the other factors is a simplistic approach (9). Of course, one of the major problems is the difficulty in establishing the training programs so that they can remove the bias toward medical relief of the drug and consequently, mitigate the severe desire of addicts (9). In spite of these challenges, the recent efforts for making interventions for reducing the implicit cognitive response of the addicts to the alcohol stimuli are very promising (9-11).

One method for preventing the mental and behavioral problems is to promote the individuals’ psychological capacity through training the social skills. Social skills include a series of capabilities that facilitate the ground for adaptation and useful and positive behavior. For life skills, which is a part of social skills, many definitions have been offered. The World Health Organization (WHO) defines the life skills as the ability to adapt and deal with life challenges properly (12). These abilities can be physical, behavioral, and cognitive (13). The attempt for teaching life skills should be focused on the middle period of education in which significant changes occur, including puberty, facing the new system of the education, and increasing importance of peer groups among the adolescents. This kind of training is practiced exclusively for inhibiting the risky behaviors and affecting the consequences of these behaviors (14).

Adolescents who have poor personal and social skills are not only vulnerable to the factors encouraging the use of drugs, but also tend to use the drug as an alternative for compromised coping strategies (15). Various studies suggested that training the social or life skills has an effective role in reducing the tendency to addiction among the adolescents (1, 16-21). In a study conducted by Bagheri, the impact of training the life skills on attitude and awareness towards the drugs, and self-esteem has been examined among junior high school students. The results indicated that training the life skills is effective on changing the students' attitude toward the drugs (22). Rahmati has evaluated the role of training the coping skills on attitudes toward the drugs in the students who participated in collective conversation session. Results showed that training the coping skills changes the students’ attitudes in the experimental group more significantly than those in the control group (23).

Teaching the social skills to the adolescents have had a significant impact on keeping them out of using drugs as well as individual risky factors such as self-concept, self-control skills, and social skills, loss of control and attitude towards the drugs (24). Nazari and Thoma in their research have suggested that there is a relationship between the poor performances of the social skills during childhood and posing the psychological problems such as delinquency, academic, and cognitive dysfunction, truancy and later during the adulthood problems like alcoholism, antisocial behaviors, and mental disorders (25, 26).

Nowadays, governments sustain an exorbitant cost for fighting against the drugs, because this subject is considered a social and personal problem. The importance of establishing the preventive strategies had been undoubtedly clear to the public for several years. In spite of increasing efforts made in line with preventing and treating the drug abuse; however, there is a growing evidence indicating that the drug use is increasing (27-29). By looking at the increasing use of drugs, especially among the young generation, it seems that they are going to be squandered who should take steps towards the construction and development of the society as a whole. Therefore, it is necessary to consider programs for preventing the addiction.

2. Objectives

With regard to the fact that the training social skills, including the increased assertiveness has been approved in reducing the behavioral disorders in different studies, the author in the present study is going to find out how training the social skills such as assertiveness, coping with anger, communication with others could be effective in reducing the tendency to addiction among the female students (adolescents).

3. Patients and Methods

The research method for this study is the semi-experimental with pretest and posttest. The study population consisted of the all-female students in Ahvaz city, using zargar addiction potential questionnaire (one standard deviation above the mean). Once the necessary coordination was made and the permission was obtained from Ahvaz Education Office, the subjects voluntarily enrolled in the experiment. Out of them, 40 students were selected and classified randomly into two groups: experimental and control group (20 persons in each group). The inclusion criteria for the research were as follows: the persons selected for participating in the study are satisfied and interested, are able to share their information and experiences, committed to treatment and therapy sessions, and their score in the zargar addiction potential questionnaire be one standard deviation higher than the mean. Also, the criteria for exiting the research included the following: announcing dissatisfaction to continue the cooperation with the researcher and incomplete response to the questionnaire.

During the experiment, all subjects participated actively in the experiment, and no dropout occurred. It should also be noted that researchers have PhD in psychology and MSc in family counseling and necessary expertise in the considered field as well as the professional experience in addiction treatment centers to perform the training sessions. Eight treatment sessions each 1.5 hours long were scheduled for the experimental group. In these sessions, the experimental group was instructed the social skills such as assertiveness skills, anger management, and how to communicate with others. In the treatment session, the subjects attempted to exercise the skills through playing the role. Meanwhile, in order to strengthen these skills out of treatment sessions, the members were instructed to pursue performing the skills at home or elsewhere. But the control group did not receive any intervention.

Research tool in this study was zargar addiction potential questionnaire. This is a customized scale for Iran, which was designed by Zargar, Najarian, and Naami (2008) regarding the psychological social conditions of Iranian community (30). This questionnaire consists of two sections; 36 articles; and 5 lie-detector articles. Each question was scored on a scale ranging from 0 (fully disagree) to 3 (fully agree). Two methods were used to determine the validity of this scale. The validity of the scale construct was calculated by correlating it with a 25 item scale of a clinical symptoms list (0.45 SCL-25) that was significant at 0.0001 level. Scale reliability was calculated by using Cronbach α as 0.90, which is desirable (30, 31).

4. Results

In this section, after presenting the descriptive results pertaining to pretest and posttest of both experimental and control groups, they were compared. The tests were examined based on the results obtained from implementation of zargari addiction potential questionnaire. As Table 1 shows, the difference between pretest and posttest scores in the experimental group is significant, and indicates an increase in the mean of posttest score over the pretest score, while the difference between pretest and posttest scores in the control group is negligible.

As seen in Table 1, the mean and standard deviation of the tendency to addiction score were 70.43, and 3.075, respectively in the pretest phase for the experimental group. These figures were 68.23 and 2.89 for the control group, respectively. In the posttest phase, they were 47.32 and 6.67, respectively for the experimental group and for the control group, 67.92 and 2.08, respectively. It means that the mean of the tendency to addiction in the experimental group in posttest has been decreased compared with the pretest in the control group.

Table 1 shows that there is a difference between the mean of the tendency to addiction among the experimental and control groups regarding the pretest and posttest. To test the significance of this difference, the ANCOVA test was used and the results are presented in Table 2. As it can be seen in Table 2, there is a significant difference between the experimental and control groups in terms of difference in the tendency to addiction scores in pretest and posttest. Therefore, the research hypothesis was confirmed. In other words, training social skills has been effective in reducing the tendency to addiction in high school female students of Ahvaz.

Table 1. Mean and Standard Deviation of Tendency to Addiction of Pre-test and Post-test Scores in Separate Groups a

5. Discussion

The purpose of the present study was to investigate the effectiveness of training social skills in reducing the level of the tendency to addiction. Nowadays, despite the substantial cultural changes and alteration in lifestyles, many people are unable to cope with life's challenges, which made them vulnerable to life problems and difficulties. To deal with these problems, it is necessary to master the life skills. Learning life skills prepares the individual for dealing with everyday life problems effectively and enables him or her to overcome challenges and tensions. The importance of life skills is such that it has been defined as the ability to cope with and manage the life challenges (30).

The results in Table 2 show that this kind of education has been effective in reducing the tendency to addiction. Therefore, the hypothesis of this research is confirmed. These findings are consistent with other researches (6, 22, 23, 32). Similarly, these findings can be partly consistent with some other studies (33-36). These researchers believe that training the life skills are effective on reducing anxiety and its components among the students. To interpret these findings, it is suggested that the susceptible people to drug use have low assertiveness and self-esteem. Thus, training the social skills enables them to increase self-esteem and assertiveness, and accordingly, the tendency to addiction is dramatically decreased as a result of having such characteristics. The people who have low self-esteem and self-concept are unable to reject the unreasonable requests of others and need to be approved by others, especially their peer groups.

They may choose the addiction as a tool for being approved by others.

One of the most important influences of life skills is to improve the individual's behavioral and motivational problems. By solving the behavioral problems, the negative feedback received from the environment is reduced significantly, promoting the individual's mental health (37). Because the addicts are constantly exposed to negative attitudes and even ostracized by their peer and society, after regaining their health through life skills training, they will establish effective communication with others. Then the negative feedback they received from others will subside and as a result, the individual's mental health is guaranteed.

Some researchers have shown that the negative self-concept is a factor that plays a role in the tendency to addiction (38). In this study, the results showed that training the social skills can also improve the mental health and create a valuable sense in people in terms of reducing their tendency to addiction. This factor was not mentioned clearly in the previous studies, and it is completely new. Studies which have already been conducted in this field approve this notion (17-21).

Today, drug dependence and abuse is a personal, social, and health problem, which is considered a threat for national human resources and social capital in different countries. In recent years, the addiction problem has shown an upward trend. Unfortunately, instead of focusing on long-term policy based on the practical approach, no serious attention has been paid to addiction and social responses so far, which is not consistent with the objectives of health promotion and prevention. However, no active policy is taken in this regard. Nevertheless, the real target should be to reduce the number of victims and perpetrators of abuse. This requires the intervention of governments, local communities, judicial system, and researchers. Studies conducted on the adolescent behavioral problems manifested as delinquency (and sometimes lead to their arrest), suggesting that educational problems, lack of self-control skills and efficient problem-solving skills, and failure to control the emotions, make a person 9living in difficult situations) to do the wrong behaviors that will separate them from the path of healthy living.

If the students are given a proper education, the occurrence of such cases can be reduced. Students as individuals who will shape the community's future, should they learn social skills, have the opportunity to benefit from the life with better productivity and become a more effective member in their community (16). Because the study was conducted among female high school students, results can only be generalized to this group. In addition, due to the time constraints, performing the follow-up to evaluate the effectiveness of social skills training over time was not possible. Therefore, the present study and the studies in this field suggest that the life skills training can reduce the tendency to addiction and applying the effective educational preventive methods is recommended. Students as the persons, who will form the future of our society, learn the social skills. Enjoying these skills, they can have the opportunity to live with greater productivity and more effectiveness as they appear in the community. Finally, we suggest that future researches investigate the role of personality characteristics, such as psychological hardiness and self-expression (that seem to be significant) in tendency to addiction.

Acknowledgements

The authors sincerely thank all the subjects who contributed to this study.